Provider Demographics
NPI:1245803139
Name:BABAYEVA, YULYA (MS)
Entity Type:Individual
Prefix:
First Name:YULYA
Middle Name:
Last Name:BABAYEVA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14715 78TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3535
Mailing Address - Country:US
Mailing Address - Phone:718-971-4959
Mailing Address - Fax:
Practice Address - Street 1:14715 78TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3535
Practice Address - Country:US
Practice Address - Phone:718-071-4959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1424349201252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency